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IT applications that support aging in place: seven categories of need Mike Rosen Outgoing Director Rehabilitation Engineering Labs National Rehabilitation Hospital Disclaimer: This talk is about meeting the needs of elders by using technology. Therefore it will focus on technology. It is, however, the position of the speaker, his colleagues and family that IT must be applied in the context of an integrated consumer- centered system of health care and support for independent living.

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Seven killer apps that support life and living Emergency detection and response-cuing Emergency detection and response-cuing Activity tracking for status monitoring Activity tracking for status monitoring Task sampling for status monitoring Task sampling for status monitoring Health maintenance Health maintenance Cognitive support in ADLs Cognitive support in ADLs Enhanced communication with the outside Enhanced communication with the outside Access to information and stimulation Access to information and stimulation Note: first three are about service delivery; last three are assistive; fourth one can be either depending on ones model of health care.

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the premise… Unobtrusive monitoring of selected ADLs in the home is technically feasible and practical. Unobtrusive monitoring of selected ADLs in the home is technically feasible and practical. Performance of ADLs is the most direct and ecologically valid indicator of functional status (and rehab outcome). Performance of ADLs is the most direct and ecologically valid indicator of functional status (and rehab outcome). ADL event time records can be processed to return meaningful estimates of global functional status for display to OTs and other remote service providers … ADL event time records can be processed to return meaningful estimates of global functional status for display to OTs and other remote service providers … without video without video

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NRH project design … First: develop and demonstrate a prototype sensor package and data- acquisition hardware and software for installation in a kitchen: done First: develop and demonstrate a prototype sensor package and data- acquisition hardware and software for installation in a kitchen: done Wired Independence Square at NRH

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unobtrusive sensors: so far just switches Is the faucet running? Is the cabinet open? Is the stove on? in-line flow switch micro-switch magnetic proximity switch

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possible performance metrics … Durations, e.g. event-to-event Durations, e.g. event-to-event Counts, e.g. # times refrigerator was opened Counts, e.g. # times refrigerator was opened Categorical: yes/no Categorical: yes/no Spatial distance moved Spatial distance moved Rates, events per time Rates, events per time Normalized by optimal or norm or contract with therapist Normalized by optimal or norm or contract with therapist

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status … Sensor package in place in Independence Square at NRH … Sensor package in place in Independence Square at NRH … with funding from NIDRR via the RERC on Telerehab, and from the U.S. Army Medical Research and Materiel Command with funding from NIDRR via the RERC on Telerehab, and from the U.S. Army Medical Research and Materiel Command OT research partner, trained in AMPS (Assessment of Motor and Process Skills), has tested five subjects with left CVA OT research partner, trained in AMPS (Assessment of Motor and Process Skills), has tested five subjects with left CVA In-home validation studies proposed, both cross-subject and longitudinal In-home validation studies proposed, both cross-subject and longitudinal

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For example: Application of mass-market technologies such as PDAs and GPS Application of mass-market technologies such as PDAs and GPS Purpose-designed software and human interfaces* for prompting during home-based ADLs, e.g. cooking: cognitive orthoses Purpose-designed software and human interfaces* for prompting during home-based ADLs, e.g. cooking: cognitive orthoses Integrated smart home solutions, e.g. networking contents-monitoring refrigerator with shopping service; or digital voice prompts about safety issues such as door locking or remembering to shut off the stove Integrated smart home solutions, e.g. networking contents-monitoring refrigerator with shopping service; or digital voice prompts about safety issues such as door locking or remembering to shut off the stove Note: this need is not limited to elders. This is universal assistive technology. *Elliot Cole, Institute for Cognitive Prosthetics

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More notes: The majority of the products noted here are sold to the mass market. Elders are themselves a huge and growing market; but many of these IT apps or their core technologies suit virtually the entire population. The majority of the products noted here are sold to the mass market. Elders are themselves a huge and growing market; but many of these IT apps or their core technologies suit virtually the entire population. In telehealth, communication and cognitive support, mass-market convergence products can become specialty tools -- 3G video smart phones, for example, for telehealth. In telehealth, communication and cognitive support, mass-market convergence products can become specialty tools -- 3G video smart phones, for example, for telehealth.